Detection of folate deficiency in alcoholism using the peripheral blood lymphocyte deoxyuridine suppression test

Twenty-seven alcoholic patients were studied for folate status. Twenty-two (81%) had neutrophil hypersegmentation and were detected as folate deficient by also having low serum folate, erythrocyte folate, lymphocyte folate and/or an abnormal peripheral blood lymphocyte deoxyuridine suppression test. Seventeen (63%) had an abnormal lymphocyte deoxyuridine suppression test and all 17 were corrected by the addition of methyltetrahydrofolate or pteroylglutamate. Comparison of these 63% abnormal (corrected by folate) results using the peripheral blood lymphocyte deoxyuridine suppression test with the lower percent abnormal (corrected by folate) bone marrow deoxyuridine suppression tests found in folate-deficient alcoholics by others suggests that the peripheral blood deoxyuridine suppression test may be more useful than the bone marrow deoxyuridine suppression test for laboratory diagnosis of folate deficiency responsive to folate therapy in alcoholism. Hidden iron deficiency is common in alcoholism, and in the concomitant presence of deficiencies of hemoglobin synthesis and of folate, the serum and erythrocyte folate and deoxyuridine suppression test in bone marrow are frequently normal, despite the suppression test being abnormal in lymphocytes and corrected by folate.